Boston, MA, USA – Psychotherapy interventions are likely to offer a safer profile with respect to fatal and non-fatal suicide attempts than selective serotonin reuptake inhibitors (SSRIs) in the longer-term management of pediatric major depressive disorder (MDD).
MDD among children and young adults is quite common, affecting approximately one in every 9 youth at some point during their teenage years. The study, “
Modeling the Risks and Benefits of Depression Treatment for Children and Young Adults” by Soeteman et al., published in
Value in Health, found that cognitive behavioral therapy (CBT) offers a safer profile with respect to suicide attempts, compared with SSRI use in combination with CBT and especially SSRI use alone.
In addition, the study found that the optimal long-term treatment strategy in terms of symptom-free weeks depends on treatment effects over time, for which there is little available clinical data. Says Dr. Djora Soeteman of the Center for Health Decision Science, “Any additional benefits of SSRIs, either alone or in combination with CBT, with respect to symptom-free weeks must be weighed against the expected increase in suicidal behavior.”
Epidemiological and clinical data from the published literature were incorporated into a disease simulation model in order to indicate the treatment that generates the highest health gains and the lowest health risks. Future research should consider the costs associated with the burden of depression, treatment interventions, and suicide attempts to determine the cost-effectiveness of depression treatments, which may be an important consideration by policy makers in identifying the optimal approach to managing depression in children and young adults.
Value in Health (ISSN 1098-3015) publishes papers, concepts, and ideas that advance the field of pharmacoeconomics and outcomes research as well as policy papers to help health care leaders make evidence-based decisions. The journal is published bi-monthly and has over 8,000 subscribers (clinicians, decision makers, and researchers worldwide).
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